Authorities: Psychiatrist sent more than 50,000 fraudulent Medicare, Medicaid nursing home claims

A Chicago psychiatrist is accused of submitting $190,000 in false claims to Medicare and Medicaid and receiving kickbacks for prescribing antipsychotics.

Michael J. Reinstein, M.D., also allegedly submitted at least 50,000 claims to Medicare and Medicaid, saying he provided “pharmacologic management” for patients at more than 30 area nursing homes and long-term care facilities, the Department of Justice said Thursday.

“This is the largest civil case alleging prescription medication fraud against an individual ever brought in Chicago,” said Gary S. Shapiro, Acting United States Attorney for the Northern District of Illinois

Clozapine, which is prescribed to treat schizophrenia, is under scrutiny in the case: The DOJ says that at one point Reinstein had 1,000 patients on Clozaril as part of an agreement with Novartis to promote the drug. After that agreement ended in 2003, IVAX Pharmaceuticals, Inc. began paying a $50,000 “consulting fee” to Reinstein in exchange for him prescribing generic clozapine, the lawsuit says. Officials say that the physician then “became the largest prescriber of generic clozapine in the country.”

Drug substitutions saved the government $13 million last year, but more drug substitutions under Medicare Part B would have saved an additional $6 million, the Office of Inspector General for Health and Human Services concluded in a recent report to Congress.